FORM 1023-EZ for FORGOTTEN MOM INC

Field Data
EIN 81-3927817
Case Number EO-2016270-000373
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FORGOTTEN MOM INC
Organization’s Mailing Address 2900 N MILITARY TRAIL - SUITE 107
City BOCA RATON
State FL
ZIP 33431
Accounting period End 12
Primary contact name FARID DALLAL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FARID DALLAL
PRESIDENT
2900 N MILITARY TR - SUITE 107
BOCA RATON FL 33431

Officer/Director/Trustee Two

JOSEPH TORO
SECRETARY
2900 N MILITARY TR - SUITE 107
BOCA RATON FL 33431

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/22/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P42 - Single Parent Agencies, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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